joshi et al., 2013 glutamate activity in acc statistical significance: **p≤0.01 spectroscopy in...
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Joshi et al., 2013
Glutamate Act iv i ty in ACC
dACC0
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1.4
1.6
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**1.5
TDASD
Mea
n G
luta
mat
e le
vels
(IU)
Statistical Significance: **p≤0.01
Spectroscopy in Adolescent Males with HF-Autistic Disorder
Higher glutamate in this area of the brain is hypothesized to be associated with ASD.
Clinical Trials Registration @ ClinicalTrials.govRegistration Number: NCT01333865URL: http://www.clinicaltrials.gov/ct2/show/NCT01333865
Study Approved by: Partners Human Research Committee Institutional Review Board
Study Funded by: the Norma Fine Pediatric Psychopharmacology Fellowship Fund & the Pediatric Psychopharmacology Council Fund
12-week Open-label Trial of Anti-Glutamate Agent
Memantine Hydrochloride (Namenda)
for the Treatment ofSocial Impairment in Young Adults with
High-functioning Autism Spectrum Disorder
Clinical and Research Program in Pediatric Psychopharmacology
ASD Features: Mean ResponseInformant-Rated: Social Responsiveness Scale (SRS)
Clinical and Research Program in Pediatric Psychopharmacology
0 6 1260
70
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100
Weeks
SRS
Mea
n Sc
ore
SRS: Mean Raw ScoreBaseline: 99 ±17Endpoint: 71 ±18
Reduction: 28 ±25Effect Size: 1.57
Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001
***
Take away: Caretakers rated patients to have improvements in social skills and behavior after trial of Namenda.
0 6 1210
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Weeks
ASD
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Socia
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Socia
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rism
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Baseline Endpoint
Me
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Sco
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Total Mean Response
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Mean Response by Domain
ASD-RS Mean TotalBaseline: 31 ±7.4Endpoint: 21 ±8.3
Reduction: 10 ±7Effect Size: 1.30
Clinical and Research Program in Pediatric Psychopharmacology
Clinician-Rated: ASD Rating Scale
ASD Features: Mean Response
Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001
Non-verbal Communication Performance
Clinical and Research Program in Pediatric Psychopharmacology
Reading Non-Verbal Emotional Cues: DANVA2 Performance
Total Errors
Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001
Paralanguage Faces0
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Baseline Endpoint
To
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core
Take Away: After medication, patients show increase in abiity to recognize emotions conveyed through facial expressions
Adverse Events
Clinical and Research Program in Pediatric Psychopharmacology
Reported > I visit
Experienced any AEs: 6 (33.3%)
Serious AEs: None
Treatment Limiting AEs: N=1Decreased energy,emotional numbness,feeling dissociated,feeling on edge(resolved on d/c)
Musculoskeletal
Decreased energy
Insomnia
Cold/Infection/Allergy
Headache
0% 2% 4% 6% 8% 10% 12%
Subjects (%)
Take away: Patients reported very few adverse side effects while on Namenda
Reimer, Fried, Biederman et al., 2013
Impaired driving ability associated with autism
The MIT AgeLab Driving Simulator
Character iz ing Dr iv ing Behavior
in Young Adults wi th ASD
Difficulties attending to the roadway:
- Higher vertical gaze position
- Wider dispersion of horizontal gaze scanning
- Focus more on the median
Drive at higher level of arousal:
- Increased level of anxiety